LipidProfile
Contents
Total -1
Cholesterol
Triglycerides-2
HDL Cholesterol-3
LDL Cholesterol-4
Apolipoproteins -5
A-1, A-ll , B, C-11,
C-lll and E
Lipoprotein (a)-6
Lipid Profile
Triglycerides
Triglycerides are the main component of animal fats and
vegetable oils.
They consist of fatty acids linked to a glycerol backbone.
High triglyceride levels increase the atherogenicity of HDL
and LDL.
LDL cholesterol
Low-density lipoprotein, or LDL, carries about 65%
.of the cholesterol in blood
The cholesterol carried by Low Density Lipoproteins is
described as 'bad cholesterol' since LDL transports
cholesterol to the tissues and is linked to the development
of
atherosclerotic lesions.
Lowering LDL levels is the principal target of
Cardiovascular disease (CVD) therapy.
Accurate LDL measurement is vital to establish CVD risk
and to determine whether patients are achieving their LDL
.targets through therapy
Many laboratories still calculate LDL using the Friedewald
equation:
LDL = TC - HDL VLDL (VLDL is calculated from triglycerides)
Cholesterol
is a soft, fat-like substance found in the
bloodstream and in all your body's cells. Your body
makes all the cholesterol it needs.
Low-density lipoprotein (LDL or 'bad') cholesterol
can join with fats and other substances to build up
in the inner walls of your arteries.
The arteries can become clogged and narrow, and
blood flow is reduced.
High-density lipoprotein (HDL or 'good') carries
harmful cholesterol away from the arteries and
helps protect you from heart attack and stroke.
Lipoproteins
About lipoproteins
Lipoproteins are lipid-protein complexes that transport
cholesterol and triglycerides in the bloodstream.
They are HDL, LDL, VLDL and chylomicrons.
The lipoproteins have similar structures but are different
sizes, densities and compositions.
They exist in a state of dynamic equilibrium, transferring
cholesterol and triglycerides between each other.
Individual lipoproteins can change size and density or be
converted into other lipoproteins
Relative lipoprotein sizes
1 Chylomicron
2 VLDL (Very Low Density Lipoprotein)
3 LDL (Low Density Lipoprotein)
3
4
Lipoprotein structure
Cholesterol Ester
45%
Phospholipids 20%
Free Cholesterol
7.5%
Triglycerides 7.5%
Apolipoprotein 20%
A p o li p o p r o t e i n s
Why measure apolipoproteins?
Apolipoproteins and the ratio between them are useful in
the assessment of cardiovascular risk.
They have particular value in monitoring lipid lowering
therapies where HDL-C and LDL-C alone are less predictive
of future cardiovascular events.
Clinical significance
1- Apolipoproteins A-I and A-II
The main role of Apolipoprotein A-I (Apo A-I) is in the
removal of excess cholesterol from extra-hepatic tissues.
Like HDL Cholesterol Apo A-I can be described as nonatherogenic showing an inverse relationship to
cardiovascular disease risk.
Individuals with cardiovascular disease generally have
reduced levels of Apo A-I and increased levels of Apo B.
Apolipoprotein A-II (APO A-II) is a major constituent of
HDL
cholesterol and plays an important role in reverse
cholesterol
A p o li p o p r o t e i n s
A p o li p o p r o t e i n s
4-Apolipoprotein E
There are three similar isoforms of Apo E: Apo E2, E3, and
E4 with E3 being the most common.
Apo E has a variety of functions depending on the
lipoprotein.
Apo E deficiency gives rise to high cholesterol and
triglyceride levels, promoting atherosclerosis.
The polymorphism has been associated with diseases
other than cardiovascular disease, for example E4 is
implicated in Alzheimers disease
Apolipoprotein E (APO E) has many functions including
the transport of triglycerides to the liver and distribution of
cholesterol between cells.
It has also been shown to affect the formation of
atherosclerotic lesions by inhibiting platelet aggregation
Atherosclerosis
Atherosclerosis refers to the buildup of fats and cholesterol
in and on your artery walls (plaques), which can restrict
blood flow.
These plaques can also burst, triggering a blood clot.
Although atherosclerosis is often considered a heart
problem, it can affect arteries anywhere in your body.
When too much LDL (bad) cholesterol circulates in the
blood atherosclerosis is initiated by inflammatory
processes in the vessel wall in response to retained lowdensity lipoprotein (LDL) molecules.
Once inside the vessel wall, LDL molecules become
susceptible to oxidation by free radicals,and become toxic
to the cells.
The damage caused by the oxidized LDL molecules
triggers a cascade of immune responses which over time
can produce an atheroma
The body's immune system responds to the damage to the
artery wall caused by oxidized LDL by sending specialized